Exam 1 - Women, Puberty, Etc. Flashcards
Describe the interaction in gingivitis and puberty
Increased levels of estrogen/progesterone –> increase gingivitis –> Increased levels of Prevotella intermedia
4 techniques of management to puberty gingivitis
- OHI (frequent reinforcement)
- Scaling and polishing
- Antimicrobial mouthrinses (CHX)
- Local/systemic antimicrobials if severe and medical history indicates need.
Describe the hormones and their levels that are considered to act during pregnancy gingivitis
Decreased estrogen levels
Increased progesterone levels
4 adverse pregnancy outcomes
Pre-term birth
Low Birth Weight
Preeclampsia
Fetal Growth Restriction and Development
Name the 4 points to the hormonal relationship to gingival inflammation
- Menadione is an essential nutrient for P. intermedia
- P. intermedia can substitute progesterone for menadione
- Elevated progesterone levels will facilitate growth and colonization of P. intermedia
- P. Intermedia is tissue invasive and associated with gingival inflammation and pyogenic granuloma formation.
What type of dental treatment can be achieved at each trimester during pregnancy in a patient needing periodontal management.
1st trimester: No treatment/Emergency only
2nd trimester: Safest time frame for treatment
- control active disease
- eliminate potential problems
- postpone periodontal surgery
3rd trimester (last month): Selective treatment
Medications that may cause xerostomia in the older adult
Antidepressants
Antihistamines
Antihypertensives
Diuretics
Diseases that may cause xerostomia
Sjogren’s syndrome
Diabetes (poor control)
Individuals taking oral bisphosphonates for greater than 3 years may be at risk for what?
Greater risk for loss of newly placed dental implants and BIONJ following tooth extraction of periodontal surgery involving bone exposure
T or F, Risk factors are the same in all ages
True
T or F, In older adults, there are fewer patients with advanced disease
True
Oral signs and symptoms of uncontrolled diabetes leading to periodontal disease
Xerostomia Burning mouth Periodontal abscesses Dental caries Candidiasis
What patient information might lead you to believe they have uncontrolled diabetes
Family history Age > 40 yrs Classic symptoms (3 P's) Periodontal abscesses Rapid alveolar bone loss Poor response to treatment
Cellular populations at Initial, Acute and Chronic stages of inflammation
Initial –> PMN’s
Acute –> PMN’s, Macrophages, and a few lymphocytes
Chronic –> Mostly lymphocytes and Plasma cells, Few PMNs and Macrophages
Vascular component of gingival inflammation
Color
Edema/swelling
bleeding
Is plaque necessary to initiate gingivitis and/or periodontitis
Yes
Does everybody with poor plaque control eventually develop gingivitis?
Yes
Does everybody that has gingivitis because of poor long-term plaque control eventually develop periodontitis?
No
T or F, Plaque is necessary and sufficient to initiate periodontitis
False, Necessary but not sufficient
Steroids act on what point in the inflammation cascade?
Phospholipases
Cell Membrane phospholipids –> Arachidonic acid
Singulair acts on what point in the inflammation cascade?
5-Lipoxygenase
Aspirin, NSAIDS, Cox-2, indomethacin act at what point in the inflammation cascade?
Cyclooxygenase
Arachidonic acid –> Prostaglandin
Initial lesion develops in how many days?
2-4 days
Increased GCF and vasculitis
Two basic categories of Virulence factors
- Stimulates host (more important)
- stimulates cells to release cytokines - Degrades host
- Enzymes (hyaluronidase, collagenase, etc.)
The Early lesion evolves at how many days?
4-7 days
Describe what is occurring during the early lesion
Acute inflammation persists (PMNs)
Chronic inflammatory cell infiltrate begins to appear (lymphocytes & Macrophages)
Established lesion occurs at what time period?
After 2-3 weeks
Describe what is occurring during the established lesion
Neutrophils persist but chronic inflammatory cell infiltrate dominates (Plasma cells, macrophages and lymphocytes)
Bone loss during established lesion/
No
What is the final stage of gingivitis?
Established lesion
At what stage does alveolar bone resorption occur?
The advanced lesion.
What occurs during the advanced lesion?
Activation of osteoclasts MMPs Cytokines Prostaglandins Leukotrienes
Pocket formation results from what 3 things?
Apical migration of JE
Loss of CT fiber attachment
Loss of bone